title: Children and adolescents with SLE: not just little adults.
abstract: Juvenile-onset systemic lupus erythematosus (JSLE) represents 15-20% of all SLE cases. Whilst features of this chronic complex multisystem autoimmune disorder are highly variable, children and adolescents generally present with a more severe illness than adults and accrue greater disease damage over time. JSLE has a less striking female preponderance and differs from the adult form in pattern of major organ manifestations. Corticosteroids are used in almost all children with JSLE along with the majority requiring additional immunosuppressive medications. Making the diagnosis early and optimizing disease control are essential to ensure that normal childhood and adolescent development is not impeded. In this young population, special consideration must be given to the long-term sequelae of the disease and treatment-related toxicity. There is a current lack of paediatric-specific controlled trials and treatment strategies are generally guided by adult data. The enormous psychological and social impact of the disease and its treatments upon the child or young person and their family necessitates a comprehensive, holistic, specialized multidisciplinary approach to managing JSLE.
authors.affiliation: 1Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, UK.
authors.forename: T A
authors.initials: TA
authors.lastname: Morgan
authors.forename: L
authors.initials: L
authors.lastname: Watson
authors.forename: L J
authors.initials: LJ
authors.lastname: McCann
authors.forename: M W
authors.initials: MW
authors.lastname: Beresford
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D033183:Interdisciplinary Communication; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents
keywords: JSLE; Juvenile-onset SLE; adolescence; management